Humanism represents a significant shift away from the psychoanalytic view of the individual as a neurotic, impulse-driven person with repressed psychic problems and away from the focus on and examination of the client’s past experiences. Humanism focuses on a person’s positive qualities, his or her capacity to change (human potential), and the promotion of self-esteem. Humanists do consider the person’s past experiences, but they direct more atten-tion toward the present and future.
Abraham Maslow (1921–1970) was an American psy-chologist who studied the needs or motivations of the individual. He differed from previous theorists in that he focused on the total person, not just on one facet of the person, and emphasized health instead of simply illness and problems. Maslow (1954) formulated the hierarchy of needs, in which he used a pyramid to arrange and illustrate the basic drives or needs that motivate people. The most basic needs—the physiological needs of food, water, sleep, shelter, sexual expression, and freedom from pain—must be met first. The second level involves safety and security needs, which include protection, security, and freedom from harm or threatened deprivation. The third level is love and belonging needs, which include enduring intimacy, friendship, and acceptance. The fourth level involves esteem needs, which include the need for self-respect and esteem from others. The highest level is self-actualization, the need for beauty, truth, and justice.
Maslow hypothesized that the basic needs at the bot-tom of the pyramid would dominate the person’s behavior until those needs were met, at which time the next level of needs would become dominant. For example, if needs for food and shelter are not met, they become the overriding concern in life: the hungry person risks danger and social ostracism to find food.
Maslow used the term self-actualization to describe a person who has achieved all the needs of the hierarchy and has developed his or her fullest potential in life. Few peo-ple ever become fully self-actualized.
Maslow’s theory explains individual differences in terms of a person’s motivation, which is not necessarily stable throughout life. Traumatic life circumstances or compromised health can cause a person to regress to a lower level of motivation. For example, if a 35-year-old woman who is functioning at the “love and belonging” level discovers she has cancer, she may regress to the “safety” level to undergo treatment for the cancer and pre-serve her own health. This theory helps nurses under-stand how clients’ motivations and behaviors change dur-ing life crises .
Carl Rogers (1902–1987) was a humanistic American psychologist who focused on the therapeutic relationship and developed a new method of client-centered therapy. Rogers was one of the first to use the term client rather than patient. Client-centered therapy focuses on the role of the client, rather than the therapist, as the key to the healing process. Rogers believed that each person experi-ences the world differently and knows his or her own experience best (Rogers, 1961). According to Rogers, cli-ents do “the work of healing,” and within a supportive and nurturing client–therapist relationship, clients can cure themselves. Clients are in the best position to know their own experiences and make sense of them, to regain their self-esteem, and to progress toward self-actualization.
The therapist takes a person-centered approach, a sup-portive role, rather than a directive or expert role, because Rogers viewed the client as the expert on his or her life.
The therapist must promote the client’s self-esteem as much as possible through three central concepts:
· Unconditional positive regard—a nonjudgmental caring for the client that is not dependent on the client’s behavior
· Genuineness—realness or congruence between what the therapist feels and what he or she says to the client
· Empathetic understanding—in which the therapist senses the feelings and personal meaning from the client and communicates this understanding to the client.
Unconditional positive regard promotes the client’s self-esteem and decreases his or her need for defensive behavior. As the client’s self-acceptance grows, the natural self-actualization process can continue.
Rogers also believed that the basic nature of humans is to become self-actualized, or to move toward self-improvement and constructive change. We are all born with a positive self-regard and a natural inclination to become self-actualized. If relationships with others are supportive and nurturing, the person retains feelings of self-worth and progresses toward self-actualization, which is healthy. If the person encounters repeated conflicts with others or is in nonsupportive relationships, he or she loses self-esteem, becomes defensive, and is no longer inclined toward self-actualization; this is not healthy.